[hypoglycaemia] Flashcards
plasma glucose <3 mmol/L
confusion drowsiness visual disturbances seizures coma
sweating
anxiety
palpitations
tremor
Overdose with sulfonylurea or insulin
EXPLAIN
exogenous drugs Pituitary insufficiency Liver failure Addisons Islet cell tumour/insulin-r antibodies Non-pancreatic neoplasms
B-blockers
pentamidine
liver failure
insulin
glucose
C-peptide
plasma ketones
indicates the level of insulin even if the pt is on insulin therapy. can differentiate the cause of hypoglycaemia
connect insulins A chain to B chain during synthesis, then is released in equimolar amounts to insulin
exogenous insulin overdose
Sulfonylureas
insulinoma
anti insulin receptor antibodies
non-pancreatic neoplasm
alcohol
pituitary insufficiency
addisons
Hodgkins
fingerprick
72 fasting glucose
post prandial (dumping syndrome)
Sugar and starch (e.g. toast)
25-50 ml glucose 50% IV
Glucagon IM 1mg
MEN 1
insulinomas
symptoms come with fasting or exercise
recorded hypoglycaemia with symptoms
symptoms releived by glucose
high insulin and low glucose during a fast
exogenous insulin given
measure c-peptide
should suppress
excision